Any Coumadin users amongst us who use nasal masks?

[jimnsc]

Just wondering because I'm having to stop using my nasal mask for several nights and use nasal pillows instead. On the tip of my nose I get a purple blotch and was thinking Coumadin may be causing that. I turn from side to side and possibly irritate the tip of my nose by physical contact with the mask. For those of you who do not know, Coumadin (a blood thinner) allows you to bruise easily and you may not even know when it occurred. Of course age makes that even worse. I can bump the back of my hand on the kitchen counter and wake up the next morning with a purple bruise there. F&P cushions don't clear my rather sizable proboscis very much anyway.

Any thoughts or similar experiences?

[sandman19]

JIMNSC, How are the nasal pillows working out? Is the area on your nose getting better? Can you continue using them instead of the mask? Is there a different mask that would fit better and not put pressure on your nose? Good luck!

[Slinky]

jimnsc, how often are they running blood draws to check your INR?? Perhaps your coumadin dosage needs to be reduced a skosh or your levels checked and dosage adjusted more often?

I'm on coumadin and have not had anywhere near so much bruising as you seem to encounter. We've had a time adjusting my dosage w/too high, too low, just right .... and I've had to do frequent blood draws for the entire past year that I've been on coumadin rather than like 6 years ago where we ran maybe 4-5 draws and stayed at the final dosage the entire 6 months I was on it. Even then I seldom had bruising problems.

Have you and your doctor given any consideration to Pradaxa or any of the other meds in that class in place of the coumadin?

[Kairosgrammy]

I agree with Slinky. Are you having your levels checked regularly? I don't mean to scare you, my sister's doctor raised her coumidin too much and because of it, she literally bled to death. Our bodies change continually and coumidin levels in your blood should be checked once a month and if the dose changes, you need it checked at least weekly. If you are bruising that easily, your dosage may be too high.

Just wondering because I'm having to stop using my nasal mask for several nights and use nasal pillows instead. On the tip of my nose I get a purple blotch and was thinking Coumadin may be causing that. I turn from side to side and possibly irritate the tip of my nose by physical contact with the mask. For those of you who do not know, Coumadin (a blood thinner) allows you to bruise easily and you may not even know when it occurred. Of course age makes that even worse. I can bump the back of my hand on the kitchen counter and wake up the next morning with a purple bruise there. F&P cushions don't clear my rather sizable proboscis very much anyway.

Any thoughts or similar experiences?

[chunkyfrog]

When will they have a home test for that?

[Kairosgrammy]

I hope never. I'd hate to have to stick myself in my vein and then forage around looking for the vein that I've missed. At least when someone else does it, I can glare at them.

When will they have a home test for that?

[Slinky]

There IS a home test! No need to draw from a vein. A simple finger prick will do. I've read about it and intend to discuss it w/my cardiologist when I next see him. His NP says that he has a few of his patients using it w/his blessing and some he discourages from going that route. He has his reasons I'm sure so I would probably defer to his recommendation on this issue.

[Kairosgrammy]

Wow, I bet my sister would have loved that. She hated the monthly draws and wasn't very good with needles. She was diabetic and stuck herself several times a day without a problem. That would have been quite a solution for her.

There IS a home test! No need to draw from a vein. A simple finger prick will do. I've read about it and intend to discuss it w/my cardiologist when I next see him. His NP says that he has a few of his patients using it w/his blessing and some he discourages from going that route. He has his reasons I'm sure so I would probably defer to his recommendation on this issue.

[jimnsc]

Good ideas and good questions and I'll try to touch on most as I can remember them.
- I am checked once monthly (INR) and had been on the same dosage for about 2 years.
- My bruising actually began prior to my dosage being increased 3 months ago - think that's what got me so concerned that I posted.
- Pradaxa was discussed at my instigation but doc said 'no due to my age (70+)
- Pillows do okay but never give me as good results as the nasal mask does (especially leak rates and AHI).
- Forgot to mention it but each time my dosage is changed they do an INR every three weeks until satisfied with dosage.

My age plus Coumadin usage has rewarded me [:-)] with regular purple blotches, usually on my hands and arms due to bruising and it's not hard to come by a new one every day or two. This is the first time I've had one on the left tip of my nose and call me vain, but my wife has touched it up with some of her beige colored make-up to hide it. Had it occurred after my dosage increase I would have suspected the increase as the villain.

I get passing AHI's with the Swift LT (2.5 or less) but I get outstanding results with the F&P Acclaim II (0.3-1.7). I own every nasal appliance made by F&P but the cheapest does the best job for me and I have deduced it is because of the absence of a protruding bias diffuser in front of the mask. If you look at the difference between the Acclaim II and the other models you can see what I mean. I am an active side to side sleeper and fare much better without something protruding out front. The only mask I do not have is the Zest for the above reasons.

I have just about determined that when I turn I probably mash the cushion briefly against the tip of my nose but I don't think the cushion is to blame (maybe) - heck I just don't know. Hence I posted for ideas. No point in my approaching F&P as I understand why they wouldn't be interested in a slightly larger cushion when what they offer 'fits most.' Just grasping at straws and curious as to whether I was alone with this concern or if there were others like me. I do not strive for 0.0 AHI's but I naturally want the best I can get.

Thanks again for your comments/questions. Not only were they helpful they showed concern and I appreciate that. As info - I have been through 2 cycles of changing from nasal mask to nasal pillows (off the mask three days and on pillows). All kinds of things went through this old curious mind - whether it could it be humidification, physical contact or both. I'll continue to try different things. This forum has been most helpful to me in 'learning the ropes of XPAP usage and I thank our host for providing it.

[jimnsc]

There IS a home test! No need to draw from a vein. A simple finger prick will do. I've read about it and intend to discuss it w/my cardiologist when I next see him. His NP says that he has a few of his patients using it w/his blessing and some he discourages from going that route. He has his reasons I'm sure so I would probably defer to his recommendation on this issue.

I agree Slinky on deferring to the doc's opinion but can you purchase the test at a CVS? Have any more info on it (meter like the blood sugar ones or strips)?

[thud]

You can home test your INR if your doctor participates in a home INR program with an INR machine Manufacturer. Like someone said, you don't take from the vein, you just prick you finger tip and get the sample from there. Drawing from a vein is old hat and mostly this is done at a lab or in doctors office who do NOT have an INR machine. I test my INR at home with a machine. Its by Philps/Alere and they partner with your doctor. They send you a machine, test strips, and lancets. You test your blood INR once per week. Then you phone the INR number into a 1-800 number. After that the INR monitoring team(at Philips) will fax your doctor the results. Then later that day your doc's office will call you and advise to increase or decrease or stay on the same coumadin dosage. This is so much better for me because my doctor is 12 miles from me one way. This is covered by Medicare. If you have a medigap policy is should cover the 20% that medicare does not pay. If your medigap does not cover it(most should) you could be responsible for the 20%. You can read about the program my doctor uses at this link.

http://www.alere.com/EN_US/products-and ... /index.jsp

[Slinky]

Philps/Alere as in Philips Respironics ????

[adrianne]

Philps/Alere as in Philips Respironics ????

http://www.healthcare.philips.com/us_en/

[thud]

Philps/Alere as in Philips Respironics ????

Yes, part of Philips. They have quite a lot of services available.